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Risk factors for virological failure and subtherapeutic antiretroviral drug concentrations in HIV-positive adults treated in rural northwestern Uganda

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dc.contributor Epicentre, Paris, France; Médecins Sans Frontières, Arua, Uganda; Laboratory of Virology, Paris Descartes University, Paris, France; Laboratory of Toxicology, Bicêtre Hospital, Kremlin Bicêtre, France; Médecins Sans Frontières, Paris, France; Medical and Administrative Hospital Direction, Arua Regional Hospital, Arua, Uganda; International and Environmental Health, Institute of Social and Preventive Medicine, Bern, Switzerland
dc.creator Ahoua, L
dc.creator Guenther, G
dc.creator Pinoges, L
dc.creator Anguzu, P
dc.creator Chaix, M L
dc.creator Le Tiec, C
dc.creator Balkan, S
dc.creator Olson, D
dc.creator Olaro, C
dc.creator Pujades-Rodriguez, M
dc.date 2009-06-03
dc.date.accessioned 2017-01-31T07:14:29Z
dc.date.available 2017-01-31T07:14:29Z
dc.identifier BMC Infect Dis 2009;9(1):81
dc.identifier 1471-2334
dc.identifier 19493344
dc.identifier 10.1186/1471-2334-9-81
dc.identifier http://hdl.handle.net/10144/71874
dc.identifier http://fieldresearch.msf.org/msf/handle/10144/71874
dc.identifier BMC Infectious Diseases
dc.identifier.uri http://dspace.mediu.edu.my:8181/xmlui/handle/10144/71874
dc.description ABSTRACT: BACKGROUND: Little is known about immunovirological treatment outcomes and adherence in HIV/AIDS patients on antiretroviral therapy (ART) treated using a simplified management approach in rural areas of developing countries, or about the main factors influencing those outcomes in clinical practice. METHODS: Cross-sectional immunovirological, pharmacological, and adherence outcomes were evaluated in all patients alive and on fixed-dose ART combinations for 24 months, and in a random sample of those treated for 12 months. Risk factors for virological failure (>1,000 copies/mL) and subtherapeutic antiretroviral (ARV) concentrations were investigated with multiple logistic regression. RESULTS: At 12 and 24 months of ART, 72% (n=701) and 70% (n=369) of patients, respectively, were alive and in care. About 8% and 38% of patients, respectively, were diagnosed with immunological failure; and 75% and 72% of patients, respectively, had undetectable HIV RNA (<400 copies/mL). Risk factors for virological failure (>1,000 copies/mL) were poor adherence, tuberculosis diagnosed after ART initiation, subtherapeutic NNRTI concentrations, general clinical symptoms, and lower weight than at baseline. About 14% of patients had low ARV plasma concentrations. Digestive symptoms and poor adherence to ART were risk factors for low ARV plasma concentrations. CONCLUSIONS: Efforts to improve both access to care and patient management to achieve better immunological and virological outcomes on ART are necessary to maximize the duration of first-line therapy.
dc.language en
dc.relation http://www.biomedcentral.com/1471-2334/9/81
dc.rights Archived with thanks to BMC infectious diseases
dc.title Risk factors for virological failure and subtherapeutic antiretroviral drug concentrations in HIV-positive adults treated in rural northwestern Uganda
dc.type Article

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